Intramedullary nails were first used in the 1930s. These early nails were inserted into the intramedullary canal of the femur. The result was immediate fixation of femur fractures, resulting in reduced patient recovery time, increased mobility, and increased quality of life. Multiple examples of such nails are present in the prior art.
But rotation of the inserted nails was a problem because rotation would result in the nail being in a position different than that chosen by the surgeon. To address this issue, wires and/or screws were used to fix the rotational position of the nail with respect to the bone. The screws were installed through the outer surface of the bone, and required additional holes through the bone to allow the wire or screws to reach the nail.
These additional screws often had associated plates, changing the profile of the bone, potentially causing irritation to surrounding tissue. The most significant problem caused by the requirement of additional fasteners is the additional time required under exposure to x-ray radiation. X-ray radiation is damaging to the patient, but is especially troublesome to the surgeon because each surgeon must perform many of these surgeries.
What is needed is a system that will provide support and positioning to a bone during patient recovery, while being minimally invasive, and with minimal side effects for the patient and surgeon.